The use of bedaquiline in the treatment of NTM disease in the UK

Bedaquiline is a diaryloquinolone antimicrobial drug that inhibits mycobacterial adenosine triphosphate synthase and is used in the treatment of multidrug resistant tuberculosis. There has been growing interesting in the utility of bedaquiline in the treatment of NTM infections, as in vitro studies have demonstrated that it may have efficacy against isolates of Mycobacterium abscessus (MAB) and Mycobacterium avium complex (MAC), as well against NTM strains that are resistant to macrolide antibiotics. However, there are currently no data from clinical trials regarding the efficacy of bedaquiline in the clinical treatment of NTM infection, and there is a lack of robust evidence regarding which patients would most likely benefit from its use.

This study aims to address this important area of unmet need and to increase the existing evidence base by creating a UK-wide case series on the use of bedaquiline to treat both pulmonary and extrapulmonary NTM infections. We aim to collate information regarding the clinical histories and outcomes of patients who have had NTM infection treated with bedaquiline, which in turn will provide a greater understanding of when its use in NTM treatment regimens should be considered. This will be the first such national case series on bedaquiline use for NTM infections in the UK and will help to inform national guidance in the future.​